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Impacted / delayed / malpositioned / extra teeth
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1. Incomplete gemination of tooth 22
Tooth 22 exhibits incomplete gemination, resulting in fused mesial (22M) and distal (22D) segments that are connected by a central isthmus. The mesial segment exhibits typical lateral incisor morphology. The pulp canals within the mesial and distal segments of tooth 22 communicate through a central isthmus level of the apical half of the roots, which precludes separation of the two segments. The roots of the mesial and distal segments of tooth 22 are approximately 80% formed and the periodontal ligament space is visible around the entire root circumference, which suggests this tooth is not ankylosed.
Axial views of teeth 22M and 22D
These axial cross-sectional images demonstrate communication between the root canal systems of teeth 22M and 22D. The periodontal ligament space is visible around the root circumference, and there is no indication of ankylosis.
Normal tooth 21
Tooth 21 appears normal radiographically, and has not been affected by tooth 22M. The crown of tooth 22M is positioned distal to the crown of tooth 21.
Retained tooth 63 + developing tooth 23
Tooth 63 is retained and is distobuccally displaced within the dental arch due to the proximity to the crown of tooth 22D. Tooth 23 is developing normally. Inadequate mesiodistal space may be present between teeth 22D and tooth 24 once it erupts to accommodate the crown of tooth 23.
Axial views of anterior 2nd quadrant
These axial cross-sectional images demonstrate incomplete gemination of tooth 22. Tooth 21 is unaffected, but tooth 63 is distobuccally displaced.